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Providing health care to an aging population is one of the biggest challenges facing governments across Canada.

It’s also primarily a provincial responsibility, though the federal government provides a significant share of the funding.

Yet, in this election campaign, health care has barely been mentioned. It wasn’t raised in the television debate on Monday and it surfaced just once in the radio version a few days earlier.

From the lack of apparent controversy over health care, you might almost think that it wasn’t an issue with voters or that it was a problem that politicians from all parties had already solved.

Hardly.

Over the past three decades, the demands of our health care system have been elbowing aside just about everything else the provincial government does. Since 1975, the cost of feeding the public health care system has grown from a quarter of the provincial budget to more than 40 per cent today.

And polls show that health care is listed as among the most important issues with voters, especially seniors.

So health care has become the elephant in the room, a voracious beast that the parties are tiptoeing around. Their relative silence may simply reflect their lack of answers to questions that are becoming more pressing by the year.

In the 2001 election, the Liberals made the promise of “quality care, when and where you need it.” That slogan is as attractive today as it was then.

But the prospect is diminishing that governments will be able to meet that demand without significant reforms to the way we provide care and the infusion of a lot more money than taxpayers seem willing to provide to keep afloat the public system as we now know it.

While in opposition, the New Democrats had a lot to say about health care, with specific complaints about the way the Liberals were running the system.

Before he became leader, Adrian Dix was the NDP’s health critic. In his last session of the legislature in that role, Dix grilled the Liberals over a range of health care issues that one might reasonably assume would be part of the NDP’s plan to do things differently.

But when the health plank of the NDP’s platform was unveiled a couple of weeks ago, it didn’t look much different than the promises the Liberals were making and it made no mention of the issue that consumed much of his attention as a critic — the growing role of private clinics.

While in opposition, Dix attacked the government for not doing enough to investigate whether they were in violation of the Canada Health Act and to bring in penalties to prevent extra billing.

He told Sun columnist Vaughn Palmer that he wouldn’t allow doctors who worked in private clinics to also work in the public system.

He and other New Democrats also attacked the government for contracting out cleaning and other services in public health facilities.

Given the financial restraints imposed by the promise to cost out and pay for campaign promises, it’s not too surprising that the opposition complaints over the amount of money being put into health care didn’t translate into promises to pump a lot more money into the system.

Indeed, in the first year of an NDP government, funding for health care is projected to increase by just $24 million. The total increase over three years for promises announced so far is $254 million, a big boost by most standards but a lift that pales in comparison to the $50 billion already scheduled to be consumed in that period with a status quo budget.

The only change the Liberals made in more than a decade that the New Democrats are promising to overturn is the stripping of funding from the UBC-based Therapeutics Initiative.

Other than that, there is little to choose from between the platforms of the Liberals and New Democrats. While the Liberals have more specific promises, both parties focus on providing more services without addressing the larger question of whether the health care system can continue to expand in the same way it has for decades without reaching a breaking point.

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